• 한국환경보건학회지
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• 제32권6호
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• pp.571-577
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• 2006

Health benefits from implementing air quality control measures were assessed using the Environmental Benefits Mapping and Analysis Program (BenMAP). BenMAP developed by US EPA is a GIS-based software tool that estimates the health impacts and associated economic values connected with changes in ambient air pollution. Once a set of BenMAP-required data was collected, the health benefits from implementing Seoul Air Quality Management Plan (SAQMP), an official AQ improvement plan for Seoul Metropolitan Area, was assessed using BenMAP. The PM10 concentrations assuming the SAQMP implemented successfully were predicted with the MM5 (Mesoscale Meteorological model version 5)/CMAQ (Community Multiscale Air Quality) model. A PM 10 exposure related premature mortality function was adopted trom a well-known epidemiology study. Economic valuation functions driven from benefit transfer methods were utilized. Through the SAQMP, PM10 concentrations were estimated to be lowered by $15{\mu}g/m^3\;to\;75{\mu}g/m^3$ depending on air quality modeling grids. 5,569 premature deaths (95% CI $3,264{\sim}7,809$ deaths) could be avoided in the Seoul Metropolitan Area. The economic value of the deaths avoided was estimated to $13.2 billion $(95%\;CI\;$890\;million{\sim}$28.2\;billion)$ using the benefit transfer value. BenMAP could be a useful tool for developing effective air quality improvement policy, enabling the policy makers to anticipate the effects of regulatory changes on people's health and the economy.

• Advances in pediatric surgery
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• 제3권1호
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• pp.41-46
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• 1997

Perforation of the gastrointestinal tract in neonatal period has been associated with a grim prognosis. Recently there has been some improvement in survival. To evaluate the remaining pitfalls in management, 19 neonatal gastrointestinal perforation cases from May 1989 to July 1996 were analysed retrospectively. Seven patients were premature and low birth weight infants. Perforation was most common in the ileum(56.3%). Mechanical or functional obstruction distal to the perforation site was identified in 7 cases; Hirschsprung's disease 3, small bowel atresia 3, and anorectal malformation 1. These lesions were often not diagnosed until operation. Five cases of necrotizing enterocolitis and 1 of muscular defect were the other causes of perforation. In six cases, the cause of the perforation was not identified. Perinatal ischemic episodes were associated in five cases. Overall mortality was 15.1%. Because a considerable number of gastrointestinal perforations resulted from distal obstruction, pediatric surgeon should be alert for early identification and intervention of gastrointestinal obstruction, particularly in patients that are premature and have a history of ischemia.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.135-139
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• 2018

There has been a significant increase in the number of multiple pregnancies that are associated with a high risk of preterm delivery among Korean women. However, to date, delayed-interval delivery in women with multiple pregnancy is rare. We report a case of delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a dichorionic diamniotic twin pregnancy. The patient presented with vaginal leakage of amniotic fluid at 16 weeks of gestation and was diagnosed with a preterm premature rupture of membranes. Three days later, the first twin was delivered, but the neonate died soon after. The second twin remained in utero, and we decided to retain the fetus in utero to reduce the morbidity and mortality associated with a preterm birth. The patient was managed with antibiotics and tocolytics. Cervical cerclage was not performed. The second twin was delivered vaginally at 34 weeks and 5 days of gestation, 128 days after the delivery of the first-born fetus. This neonate was healthy and showed normal development during the 1-year follow-up period. Based on our experience with this case, we propose that delayed-interval delivery may improve perinatal survival and decrease morbidity in the second neonate in highly selected cases.

• 혜화의학회지
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• 제13권2호
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• pp.221-229
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• 2004

1.Purpose Stroke is the most frequent cause of mortality and morbidity rate in Korea with ischemic heart disease and cancer. Recent recurrence rate of stroke is high, but little attention had been given to the features of its' cause. The purpose of this studies is to examine the hematologic states in Korean normal adults through premature-examination of stroke(PES). 2.Method The study group consisted of 326 cases that they had no significant results by CT through premature examination of stroke(PES) in Cheonan oriental hospital of Daejeon university. We tested RBC, hemoglobin, hematocrit, WBC, PT, PTT, PLT, total protein, albumin, total bilirubin, direct bilirubin, GOT, GPT, $\gamma$-GTP, total cholesterol, triglyceride, HDL-C, glucose, BUN, creatinine, Na, K and evaluated by cross sectional study. 3.Result In the PES, there were many patients with low RBC(11%), shorten PT(26.7%), delayed PTT(19.3%), high TP, GPT, ${\gamma}$ -GTP(respective1y 16.9%, 14.4%, 13.5%), high cholesterol level and triglyceride level(respectively 18.7%, 28.2%). We didn't found significant cases in hemoglobin, hematocrit, WBC, PLT, albumin, total bilirubin, direct bilirubin, GOT, HDL-C, glucose, BUN, creatinine, Na, K. 4.Conclusion In this study, we demonstrated that short PT, high triglyceride level are special views in PES. Also prospective studies are needed continuously to search the preventing methods of the CVA.

• 한국기후변화학회지
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• 제7권4호
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• pp.451-463
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• 2016

We explore the impact of Chinese future air pollutant emissions on ozone air quality in Northeast Asia (NEA) and health in South-Korea using an assessment framework including ICAMS (The Integrated Climate and Air Quality Modeling System) and BenMAP (The Environmental Benefits Mapping and Analysis Program). The emissions data sets from the climate change scenarios, the Representative Concentration Pathways (RCPs) (emission scenarios, EMSO), are used to simulate ozone air quality in NEA in the current (1996~2005, 2000s), the near future (2016~2025, 2020s) and the distant future (2046~2055, 2050s). Furthermore, the simulated ozone changes in the 2050s are used to analyze ozone-related premature mortality and economic cost in South-Korea. While different EMSOs are applied to the China region, fixed EMSO are used for other country regions to isolate the impacts of the Chinese emissions. Predicted ozone changes in NEA are distinctively affected by large changes in NOx emission over most of China region. Comparing the 2020s with the 2000s situation, the largest increase in mean ozone concentrations in NEA is simulated under RCP 8.5 and similarly small increases are under other RCPs. In the 2050s in NEA, the largest increase in mean ozone concentrations is simulated under RCP 6.0 and leads to the occurrence of the highest premature mortalities and economic costs in South-Korea. Whereas, the largest decrease is simulated under RCP 4.5 leads to the highest avoided premature mortality numbers and economic costs. Our results suggest that continuous reduction of NOx emissions across the China region under an assertive climate change mitigation scenario like RCP 4.5 leads to improved future ozone air quality and health benefits in the NEA countries including South-Korea.

• Journal of Korean Neurosurgical Society
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• 제66권3호
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• pp.316-323
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• 2023

Objective : Owing to advances in critical care treatment, the overall survival rate of preterm infants born at a gestational age (GA) <32 weeks has consistently improved. However, the incidence of severe intraventricular hemorrhage (IVH) has persisted, and there are few reports on in-hospital morbidity and mortality. Therefore, the aim of the present study was to investigate trends surrounding in-hospital morbidity and mortality of preterm infants with severe IVH over a 14-year period. Methods : This single-center retrospective study included 620 infants born at a GA <32 weeks, admitted between January 2007 and December 2020. After applying exclusion criteria, 596 patients were included in this study. Infants were grouped based on the most severe IVH grade documented on brain ultrasonography during their admission, with grades 3 and 4 defined as severe. We compared in-hospital mortality and clinical outcomes of preterm infants with severe IVH for two time periods : 2007-2013 (phase I) and 2014-2020 (phase II). Baseline characteristics of infants who died and survived during hospitalization were analyzed. Results : A total of 54 infants (9.0%) were diagnosed with severe IVH over a 14-year period; overall in-hospital mortality rate was 29.6%. Late in-hospital mortality rate (>7 days after birth) for infants with severe IVH significantly improved over time, decreasing from 39.1% in phase I to 14.3% in phase II (p=0.043). A history of hypotension treated with vasoactive medication within 1 week after birth (adjusted odds ratio, 7.39; p=0.025) was found to be an independent risk factor for mortality. When comparing major morbidities of surviving infants, those in phase II were significantly more likely to have undergone surgery for necrotizing enterocolitis (NEC) (29.2% vs. 0.0%; p=0.027). Additionally, rates of late-onset sepsis (45.8% vs. 14.3%; p=0.049) and central nervous system infection (25.0% vs. 0.0%; p=0.049) were significantly higher in phase II survivors than in phase I survivors. Conclusion : In-hospital mortality in preterm infants with severe IVH decreased over the last decade, whereas major neonatal morbidities increased, particularly surgical NEC and sepsis. This study suggests the importance of multidisciplinary specialized medical and surgical neonatal intensive care in preterm infants with severe IVH.

• 한국대기환경학회지
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• 제26권1호
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• pp.10-20
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• 2010

In recent studies, $PM_{2.5}$ has been reported to be more harmful to human health than $PM_{10}$ because it penetrates more deeply into the lung. We estimated $PM_{2.5}$ related health benefits in Seoul from implementing the World Health Organization (WHO)'s guidelines (annual average $10{\mu}g/m^3$, 24-hour average $25{\mu}g/m^3$) and U.S. Environmental Protection Agency (EPA)'s National Ambient Air Quality Standard (annual average $15{\mu}g/m^3$, 24-hour average $35{\mu}g/m^3$). U.S. EPA's Environmental Benefits Mapping and Analysis Program was utilized for the analysis. It was predicted that the attainment of the WHO annual guideline and U.S. EPA's annual standard, relative to the concentration in 2006, would result in reduction of 2,333~2,895 premature deaths and 1,703~2,121 premature deaths, respectively. If the WHO and EPA's daily standard for $PM_{2.5}$ are attained, 1,211~1,394 and 1,012~1,165 premature deaths could be avoided, respectively. Sensitivity analyses indicated that the estimates were robust regardless of air quality simulation methods for attaining the $PM_{2.5}$ goals. This study provides a quantitative approach to evaluate health risks from air pollution as well as to assess the potential health benefits of improving atmospheric $PM_{2.5}$ concentration. Even considering the intrinsic limitations and uncertainties of the analysis, it is an important information to rationalize the enforcement of $PM_{2.5}$ management policies and measures in Seoul, Korea.

• Nutrition Research and Practice
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• 제11권6호
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• pp.492-499
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• 2017

BACKGROUND/OBJECTIVES: This study aimed to investigate the association of dietary patterns with overweight risk and all-cause mortality in pediatric cancer patients. SUBJECTS/METHODS: Prospective cohort study was undertaken; 83 cancer patients admitted to the pediatric cancer ward at a university hospital in Seoul were included and followed for obesity and death over 24 months. Food consumption data were collected from patients using validated meal order sheets for breakfast, lunch, and dinner at the pediatric cancer ward over 3 days. Using principal component analysis, three dietary patterns were derived from 29 food groups. RESULTS: Eighteen deaths occurred among the patient cohort during the follow-up period. The "spicy & fried meat and fish" dietary pattern was positively associated with overweight risk at both baseline [odds ratio (OR) = 4.396, 95% confidence interval (CI) = 1.111-17.385, P for trend = 0.023] and after 6 months (OR = 4.088, 95% CI = 1.122-14.896, P for trend = 0.025) as well as all-cause mortality (hazard ratios = 5.124, 95% CI = 1.080-24.320, P for trend = 0.042), when comparing the highest and lowest tertiles after adjusting for covariates. The "fish, egg, meat, and fruits & vegetables" dietary pattern was associated with lower overweight risk after 24 months (OR = 0.157, 95% CI = 0.046-0.982, P for trend = 0.084). CONCLUSION: The results imply that dietary patterns might be associated with weight gain and premature death among pediatric cancer patients.

• 한국산학기술학회논문지
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• 제13권11호
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• pp.5261-5270
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• 2012

이 연구의 목적은 우리나라의 악성신생물 중 최근 증가율이 가장 높은 대장암에 대하여 우리나라와 OECD 국가들 간에 2000년 전(1990-1999)과 2000년 후(2000-2009)의 사망률과 잠재수명손실연수(PYLL)에 통계학적으로 차이가 있는가를 살펴본 후, 대장암에 대한 국가 간 비교와 변화의 추이를 파악하여, 보건정책, 보건교육 등을 위한 자료를 제공하고자 하였다. "OECD Health Data 2012"을 사용하여 OECD 회원국 중 자료가 불충분한 2개국을 제외한 32개국에 대하여 대응표본 T검정(Paired T test) 방법을 사용해서 2000년 전과 2000년 후에 통계학적으로 차이를 살펴보았다. 남자의 대장암 사망률은 우리나라를 포함한 8개국만 2000년 후에 증가하였고, 여자의 대장암 사망률은 우리나라와 칠레만 증가하였는데 증가폭은 남녀 모두 우리나라가 월등히 높았다. 대장암 잠재수명손실연수는 2000년후에 증가폭이 우리나라가 월등히 높았는데, 남성의 경우 증가율 2위인 멕시코보다 3배 이상 증가하였고, 여성의 경우 2000년 후에 통계학적으로 유의하게 잠재수명손실연수가 증가한 나라는 우리나라가 유일하였다. 따라서, 대부분 OECD 국가는 2000년 이후 대장암 관리가 적절히 통제되고 있는 반면, 우리나라는 그렇지 못한 것으로 보이며, 특히 향후관리에 있어 여성에서 보인 잠재수명손실연수의 증가 이유에 관한 후속연구가 필요해 보인다.

• Journal of Chest Surgery
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• 제26권7호
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• pp.526-531
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• 1993

Sixty-one consecutive patients with coronary artery bypass graft for myocardial revascularization were retrospectively reviewed to analyze various pattern of postoperative complication and death during hospital stay from Nov. 1988 to Oct. 1992. Fortytwo of the patients were male and nineteen female. The mean age was 56 and 51 years in male and female. Preoperative diagnosises were unstable angina in 14 of patients, stable angina in 28, postmyocardial infarction state in 15, and state of failed percutaneous transluminal coronary angioplasty in 4. 141 stenosed coronary arteries were bypassed with use of 20 pedicled internal mammary artery and 124 reversed saphenous vein grafts. Postoperative complications and perioperative death were as follows: 1. Of 61 patients undergoing operation, peri and postoperative over all complication occured in 15 patients [ 25% ]; newly developed myocardial infarction in 4, intractable cardiac arrhythmia including atrial fibrillation and frequent ventricular premature contraction in 3, bleeding from gastrointestinal tract in 2, persistent vegetative state as a sequele of brain hypoxia in 1, wound necrosis in 1, left hemidiaphragmatic palsy in 3 and poor blood flow through graft in 2. 2. Operative mortality was 8%[5 patients]. 3 out of these died in operating room; 1 patient by bleeding from rupture of calcified aortic wall, 1 by air embolism through left atrial vent catheter, 1 by low cardiac output syndrome. 2 patients died during hospital stay; 1 by acute respiratory distress syndrome with multiuple organ failure, 1 by brain death after delayed diagnosis of pericardial tamponade.